Every hospital in England must have a “comprehensive” GP led triage system in emergency departments by October 2017 in a bid to avoid a repeat of the winter crisis that gripped the service this year, NHS leaders have said.

The requirement is one of several “concrete changes” demanded by NHS England’s chief executive, Simon Stevens, and the chief executive of NHS Improvement, Jim Mackey, in a letter sent after the chancellor Philip Hammond’s budget pledge to give the NHS an extra £100m (€115m; $120m) in 2017‑18 to spend on easing pressures in accident and emergency departments.

From October general practices in England will be financially penalised if they close during core working hours during the week, the chief executive of NHS England has said.

Simon Stevens told MPs on the House of Commons Public Accounts Committee that changes to the GP contract, which will be introduced in October, will allow NHS England to scrutinise GP opening hours more closely and take action where necessary.

Swimming, racquet sports, and aerobics seem to be the best forms of exercise for reducing the risk of death from heart disease and stroke, research published in the British Journal of Sports Medicine has found.

The researchers said that the small number of events impaired the statistical power in some analyses. There were relatively few deaths from all causes among runners and football players, which may explain the wide confidence intervals. However, they concluded, “These findings demonstrate that participation in specific sports may have significant benefits for public health.”

Please note, due to essential maintenance work on the trust’s IT systems, library computers will be unavailable at these times. See the message below for further details.

‘In order to progress the server 2003 replacement project, Midlands and Lancashire Commissioning Support Unit IT Services will be carrying out essential maintenance work overnight on Wednesday 16th November from 22:00 until 10:00 on Thursday 17th November.

This will mean that between 10pm on Wednesday 16th November and 10am on Thursday 17th November, ALL of the trust’s IT systems will not be available and you will not have access to any IT systems during this time. This will affect ALL clinical and administrative applications including Extramed Cris, Pathology, Radiology, PAS and shared drives.’

Please contact Lynda Cotterill, Library Services Manager, on 01625 663923 if you have any questions about library computers.

Taking cranberry capsules did not reduce urinary tract infections (UTIs) in older women living in nursing homes, a US randomised trial has shown.

UTIs are very common among nursing home residents: bacteriuria is detected in 25-50% of women living in nursing homes, and pyuria is present in 90% of these. Cranberry products have been of interest in preventing UTIs in this group of people, to reduce unnecessary use of antibiotics.

The role of the EDC is to help shape the future of healthcare from an equality, diversity and human rights perspective, and to improve the quality of care for all. In the first of series of blogs, co-chair of the Equality and Diversity Council (EDC), Joan Saddler provides an update from the most recent quarterly meeting and offers an insight into the latest thinking behind the programme of work.

Three in five of us will be carers at some point in our lives and for many of us these responsibilities will begin or continue into our older age. Dawn Moody, Associate National Clinical Director for Older People, marks Older Peoples Day (1 October) with a blog on the importance of caring for our carers.

The government and NHS leaders must set out a clear and compelling plan for expanding the use of digital technology to avoid losing the commitment of clinicians, the King’s Fund has said.

Digital technology can transform how patients engage with services, drive improvements in efficiency and care coordination, and help people manage their health and wellbeing, the think tank said in its report, A Digital NHS?

However, it said that expectations might have been set too high amid financial and operational pressures and that there was a lack of clarity about the funding available to support the work.

With increasing use of electronic cigarettes (e-cigarettes) and other electronic nicotine delivery systems (ENDS) globally, the debate surrounding the potential harms or benefits may shift to ensuring that the devices are manufactured, marketed, and sold according to standards that reduce harm and promote health. Burns from overheating or explosions of ENDS are an emerging and under-researched concern. In light of the recent ruling that grants the US Food and Drug Administration authority to regulate ENDS1 and as their use becomes widespread worldwide, a clinical, public health, and regulatory framework to reduce ENDS related burns is needed.

Introducing eggs or peanuts early into infants’ diet is associated with a lower risk of developing egg or peanut allergy, says a systematic review of the evidence published in JAMA.

The review found “moderate certainty” evidence that introducing eggs to the infant diet at 4 to 6 months was associated with reduced egg allergy and that introducing peanuts at 4 to 11 months was associated with reduced peanut allergy when compared with later introduction of these foods.

The type of intense extra workload pressure often experienced by the NHS in winter has become a year long experience, say experts responding to the publication of the latest official data on the performance of the NHS in England.

NHS England’s combined performance summary data show an NHS that is missing many of its targets and hitting new record lows for performance in some areas.

The BMA has warned that planned new digital NHS services, including an online “symptom checker,” should not replace patients’ direct access to GPs.

Brian Balmer, who chairs the BMA’s General Practitioners Committee, said that any new technology that improved patient care and access was to be welcomed, especially if it made appointment booking easier. But he said, “The proposed symptom checker is not the same as a consultation with a GP and should not be considered as such.”

Cardiovascular disease (CVD) mortality in the United Kingdom has decreased significantly over the past 30 years, but its prevalence has shown little change, and major differences exist in the burden of CVD among the four constituent countries and between men and women, a review has found.

Women taking combined hormone replacement therapy (HRT) are 2.7 times more likely to develop breast cancer than non-users, and the risk may increase with longer use, a study published in the British Journal of Cancer has found.

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The researchers, from the Institute of Cancer Research in London, said that previous studies may have substantially underestimated the risk of breast cancer from combined HRT, as they did not update information about a woman’s HRT use or analyse accurately to allow for her age at menopause.

The new research was part of the Breast Cancer Now Generations Study, which is following more than 100 000 women for 40 years to investigate the causes of breast cancer.

General practice leaders have called on the government and the General Medical Council to correct the “anachronistic anomaly” whereby GP postgraduate training remains unrecognised as a medical specialty in the United Kingdom.

In a joint statement,

GP leaders from the BMA and the Royal College of General Practitioners (RCGP) from across the four UK nations said that this recognition was “long overdue” given the rigorous training and examination that GPs undergo.

NHS England has announced a range of improvements to its GP retainer scheme, including increased funding for GPs and practices. The scheme provides financial incentives and development support to encourage GPs who might otherwise leave the profession to remain in general practice.

NHS England said that, from 1 July 2016, it would increase the money for practices employing a retained GP and the annual payment towards professional expenses for GPs in the scheme.

The USA and England have joined forces on two films for healthcare professionals to show how they are reducing the combined 90million people living in their countries collectively who are on-track to develop Type 2 diabetes.

Top experts from both sides of the Atlantic shared tactics to reduce the 86 million Americans and 5million people in England at increased risk of developing the disease which can cause blindness and amputation.

Irritable bowel syndrome (IBS) is a common disorder of the digestive system, affecting about 10% of the global population. The condition has no definitive biomarker or cure, but various drug treatments have been introduced in recent years, including antibiotics (to treat presumed small intestinal bacterial overgrowth) and agents that affect motility through fluid secretion or the enteric nervous system. Despite these advances, perhaps the most popular option among patients in recent years has been a dietary approach, the “low FODMAP diet.”

Maureen Bisognano, one of the keynote speakers at this year’s International Forum on Quality and Safety in Healthcare in Gothenburg, Sweden, told delegates that we should ask our patients, “What matters to you?” rather than, “What is the matter?”

The question “What matters to you?” tries to get to the essence of patient centered care, which the Institute of Medicine has listed as one of the priorities for quality improvement.